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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The three principle conditions in the differential diagnosis of a suspected perforated peptic ulcer are acute pancreatitis, acute cholecystitis, and another perforated viscus e.g. colon diverticula. Investigations are directed at discriminating these conditions and preparing patient for possible surgery.

  • blood tests - FBC, U+Es, LFTs, amylase, group and save
  • erect CXR - may show gas under the diaphragm - and plain abdominal film
  • ECG
  • gastroscopy is contraindicated: this is because the stomach is inflated during this procedure, and air and gastric contents would be propelled into the peritoneal cavity.

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